About

Sam Shen is a Clinical Professor of Emergency Medicine at Stanford Medicine with a focus on emergency department operations, digital health, quality improvement, patient safety, and health care management. He has held several leadership roles, including Patient Safety Officer at Stanford Health Care since 2019, Vice Chair of Clinical Operations & Quality at Stanford University School of Medicine since 2017, and Fellowship Director for the EM Administration Fellowship since 2015. His educational background includes an MD from UCLA David Geffen School of Medicine, a residency at Beth Israel Deaconess Medical Center, and an MBA from the Anderson School of Management at UCLA. His research and scholarly interests include emergency department process improvement, digital health, ED operations, and innovations aimed at enhancing patient safety and health care quality. He has contributed to the field through research on inpatient hallway boarding during emergency department crowding, which was published in the Annals of Emergency Medicine in 2025. Shen is actively involved in professional organizations, serving as a board member of the IHI Certification Board for Professionals in Patient Safety and as a member of the Society of Academic Emergency Medicine. His work emphasizes improving emergency care delivery and patient safety through operational and systemic innovations.

Research topics

• Medicine
• Computer Science
• Nursing
• Meteorology
• Statistics
• Mechanical engineering
• Engineering
• Anesthesia
• Software engineering
• Emergency medicine
• Internal medicine
• Business
• Operating system
• Medical emergency

Selected publications

• Adoption of Boarding in Inpatient Hallways During Emergency Department Crowding

  Annals of Emergency Medicine · 2025-07-15

  article
  PublisherDOI

• Precision emergency medicine

  Academic Emergency Medicine · 2024-06-28 · 6 citations

  articleOpen access

  BACKGROUND: Precision health is a burgeoning scientific discipline that aims to incorporate individual variability in biological, behavioral, and social factors to develop personalized health solutions. To date, emergency medicine has not deeply engaged in the precision health movement. However, rapid advances in health technology, data science, and medical informatics offer new opportunities for emergency medicine to realize the promises of precision health. METHODS: In this article, we conceptualize precision emergency medicine as an emerging paradigm and identify key drivers of its implementation into current and future clinical practice. We acknowledge important obstacles to the specialty-wide adoption of precision emergency medicine and offer solutions that conceive a successful path forward. RESULTS: Precision emergency medicine is defined as the use of information and technology to deliver acute care effectively, efficiently, and authentically to individual patients and their communities. Key drivers and opportunities include leveraging human data, capitalizing on technology and digital tools, providing deliberate access to care, advancing population health, and reimagining provider education and roles. Overcoming challenges in equity, privacy, and cost is essential for success. We close with a call to action to proactively incorporate precision health into the clinical practice of emergency medicine, the training of future emergency physicians, and the research agenda of the specialty. CONCLUSIONS: Precision emergency medicine leverages new technology and data-driven artificial intelligence to advance diagnostic testing, individualize patient care plans and therapeutics, and strategically refine the convergence of the health system and the community.

  PublisherOA PDFDOI

• Stanford Emergency Medicine Partnership Program: a novel approach to streamlining the evaluation and implementation of emerging health technologies through academic–industry partnerships

  BMJ Innovations · 2024-06-12

  articleOpen access
  PublisherOA PDFDOI

• Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic

  UNC Libraries · 2023-06-16

  articleOpen access

  Objectives The COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to the COVID-19 pandemic. Design, setting and participants This was a prospective observational study of 17 geographically diverse US hospitals from February 2020 to February 2021. Outcomes and analysis We identified 42 potential pandemic-related strategies and obtained week-to-week data about their use. We calculated descriptive statistics for use of each strategy and plotted percent uptake and weeks used. We assessed the relationship between strategy use and hospital type, geographic region and phase of the pandemic using generalised estimating equations (GEEs), adjusting for weekly county case counts. Results We found heterogeneity in strategy uptake over time, some of which was associated with geographic region and phase of pandemic. We identified a body of strategies that were both commonly used and sustained over time, for example, limiting staff in COVID-19 rooms and increasing telehealth capacity, as well as those that were rarely used and/or not sustained, for example, increasing hospital bed capacity. Conclusions Hospital strategies during the COVID-19 pandemic varied in resource intensity, uptake and duration of use. Such information may be valuable to health systems during the ongoing pandemic and future ones.

  PublisherDOI

• Observational study of organisational responses of 17 US hospitals over the first year of the COVID-19 pandemic

  BMJ Open · 2023-05-01 · 4 citations

  articleOpen access

  OBJECTIVES: The COVID-19 pandemic has required significant modifications of hospital care. The objective of this study was to examine the operational approaches taken by US hospitals over time in response to the COVID-19 pandemic. DESIGN, SETTING AND PARTICIPANTS: This was a prospective observational study of 17 geographically diverse US hospitals from February 2020 to February 2021. OUTCOMES AND ANALYSIS: We identified 42 potential pandemic-related strategies and obtained week-to-week data about their use. We calculated descriptive statistics for use of each strategy and plotted percent uptake and weeks used. We assessed the relationship between strategy use and hospital type, geographic region and phase of the pandemic using generalised estimating equations (GEEs), adjusting for weekly county case counts. RESULTS: We found heterogeneity in strategy uptake over time, some of which was associated with geographic region and phase of pandemic. We identified a body of strategies that were both commonly used and sustained over time, for example, limiting staff in COVID-19 rooms and increasing telehealth capacity, as well as those that were rarely used and/or not sustained, for example, increasing hospital bed capacity. CONCLUSIONS: Hospital strategies during the COVID-19 pandemic varied in resource intensity, uptake and duration of use. Such information may be valuable to health systems during the ongoing pandemic and future ones.

  PublisherOA PDFDOI

• Changes in low‐acuity patient volume in an emergency department after launching a walk‐in clinic

  Journal of the American College of Emergency Physicians Open · 2023-07-21 · 7 citations

  articleOpen access

  Objective Unscheduled low-acuity care options are on the rise and are often expected to reduce emergency department (ED) visits. We opened an ED-staffed walk-in clinic (WIC) as an alternative care location for low-acuity patients at a time when ED visits exceeded facility capacity and the impending flu season was anticipated to increase visits further, and we assessed whether low-acuity ED patient visits decreased after opening the WIC. Methods In this retrospective cohort study, we compared patient and clinical visit characteristics of the ED and WIC patients and conducted interrupted time-series analyses to quantify the impact of the WIC on low-acuity ED patient visit volume and the trend. Results There were 27,211 low-acuity ED visits (22.7% of total ED visits), and 7,058 patients seen in the WIC from February 26, 2018, to November 17, 2019. Low-acuity patient visits in the ED reduced significantly immediately after the WIC opened (P = 0.01). In the subsequent months, however, patient volume trended back to pre-WIC volumes such that there was no significant impact at 6, 9, or 12 months (P = 0.07). Had WIC patients been seen in the main ED, low-acuity volume would have been 27% of the total volume rather than the 22.7% that was observed. Conclusion The WIC did not result in a sustained reduction in low-acuity patients in the main ED. However, it enabled emergency staff to see low-acuity patients in a lower resource setting during times when ED capacity was limited.

  PublisherOA PDFDOI

• Effectiveness, safety, and efficiency of a drive‐through care model as a response to the COVID‐19 testing demand in the United States

  Journal of the American College of Emergency Physicians Open · 2022-12-01 · 5 citations

  articleOpen access

  Objectives: Here we report the clinical performance of COVID-19 curbside screening with triage to a drive-through care pathway versus main emergency department (ED) care for ambulatory COVID-19 testing during a pandemic. Patients were evaluated from cars to prevent the demand for testing from spreading COVID-19 within the hospital. Methods: We examined the effectiveness of curbside screening to identify patients who would be tested during evaluation, patient flow from screening to care team evaluation and testing, and safety of drive-through care as 7-day ED revisits and 14-day hospital admissions. We also compared main ED efficiency versus drive-through care using ED length of stay (EDLOS). Standardized mean differences (SMD) >0.20 identify statistical significance. Results: Of 5931 ED patients seen, 2788 (47.0%) were walk-in patients. Of these patients, 1111 (39.8%) screened positive for potential COVID symptoms, of whom 708 (63.7%) were triaged to drive-through care (with 96.3% tested), and 403 (36.3%) triaged to the main ED (with 90.5% tested). The 1677 (60.2%) patients who screened negative were seen in the main ED, with 440 (26.2%) tested. Curbside screening sensitivity and specificity for predicting who ultimately received testing were 70.3% and 94.5%. Compared to the main ED, drive-through patients had fewer 7-day ED revisits (3.8% vs 12.5%, SMD = 0.321), fewer 14-day hospital readmissions (4.5% vs 15.6%, SMD = 0.37), and shorter EDLOS (0.56 vs 5.12 hours, SMD = 1.48). Conclusion: Curbside screening had high sensitivity, permitting early respiratory isolation precautions for most patients tested. Low ED revisit, hospital readmissions, and EDLOS suggest drive-through care, with appropriate screening, is safe and efficient for future respiratory illness pandemics.

  PublisherOA PDFDOI

• Converting an ED Fast Track to an ED Virtual Visit Track

  NEJM Catalyst · 2022-10-19 · 3 citations

  article

  SummaryED patients with lower-acuity care needs often have long wait times for evaluation because of higher-acuity patients receiving priority for available beds. Challenges posed by the Covid-19 pandemic accelerated the launch in December 2020 of an already-developed and approved plan to integrate virtual visits into clinical care at Stanford. For both adult and pediatric EDs, Stanford extended this model into the emergency care environment by converting its existing Fast Track care unit into a Virtual Visit Track (VVT). This was done to speed the ability to evaluate lower-acuity patients in more than one ED with a single physician located at a satellite location. In the VVT, a remote physician provided care to lower-acuity patients who presented at either of the two sites, the pediatric ED or the adult ED. The physician is supported by virtual visit–enabling hardware, software, workflow development, and training, as well as by VVT-trained support staff. In the first 11 months, 2,232 patients received care through the VVT. Stanford met its resource investment break-even point of 12 patients seen during an 8-hour shift on day 6, but this patient volume was not sustained until 7.5 months into the program; this volume has remained constant since then. In a matched cohort of patients, the median ED length of stay (EDLOS) for VVT patients was 1.9 hours compared with 4.2 hours for patients cared for in the typical main ED workflow (P < .001). Also, 17 of 50 VVT physicians (34%) rated their ability to deliver a comparable level of care to in-person consultation as excellent, with the remaining 33 of 50 (66%) rating it as very good. The authors observed that the age range for VVT patients was 2–94 years, but overall, they were younger than a matched cohort of main ED patients. This may reflect generational differences in comfort with a virtual physician encounter. Within the matched cohort, they also found that the median return visit rate among VVT patients was lower than among those in the main ED for 72-hour revisits (6.7% vs. 7.2%; P = .60) and 7-day revisits (10.4% vs. 12.4%; P = .09), but the differences were not statistically significant. This suggests that VVT visit quality is not likely worse than main ED care for similarly lower-acuity patients. The aim was not to determine that the VVT model was superior, but rather that it was not inferior. Virtual care is a fast-growing method of care delivery. Although typically applied when a patient is outside of the care environment, a VVT program can be used in other situations in which options for in-person evaluation are limited.

  PublisherDOI

• Telemedicine to Decrease Personal Protective Equipment Use and Protect Healthcare Workers

  Western Journal of Emergency Medicine · 2020-09-24 · 8 citations

  articleOpen access

  DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

  PublisherOA PDFDOI

• A body bag can save your life: a novel method of cold water immersion for heat stroke treatment

  Journal of the American College of Emergency Physicians Open · 2020 · 25 citations

  • Medicine
  • Anesthesia
  • Meteorology

  Non-exertional heat stroke is a life-threatening condition characterized by passive exposure to high ambient heat, a core body temperature of 40°C (104°F) or greater, and central nervous system dysfunction. Rapid cooling is imperative to minimize mortality and morbidity. Although evaporative and convective measures are often used for cooling heat stroke patients, cold water immersion produces the fastest cooling. However, logistical difficulties make cold water immersion challenging to implement in the emergency department. To our knowledge, there is no documented case utilizing a body bag (ie, human remains pouch) as a cold water immersion tank for rapid resuscitation of heat stroke. During a regional heat wave an elderly woman was found unconscious in a parking lot with an oral temperature of 40°C (104°F) and altered mental status. She was cooled to 38.4°C (101.1°F) in 10 minutes by immersion in an ice- and water-filled body bag. The patient rapidly regained normal mentation and was discharged home from the ED. This case highlights a novel method for efficient and convenient cold water immersion for heat stroke treatment in the emergency department.

  PublisherOA PDFDOI

Frequent coauthors

• Maame Yaa A. B. Yiadom

  Stanford University

  10 shared

• Ryan Ribeira

  Stanford University

  7 shared

• Patrice Callagy

  Stanford Health Care

  7 shared

• Sunny Patel

  Albert Einstein College of Medicine

  5 shared

• Matthew Strehlow

  5 shared

• Andrew W. Artenstein

  5 shared

• Shefali Dujari

  Stanford University

  4 shared

• Alexie M. Wagner

  Palo Alto University

  4 shared

Labs

• Sam ShenPI

Awards & honors

• Fellow, American College of Emergency Physicians (2008 - Pre…
• Board Certified, American Board of Emergency Medicine (2006…